European Journal of Molecular & Clinical Medicine

Abstract

Background: Traditionally Open Z-Plasty lengthening is the choice of the procedure for
treating Achilles tendon contracture seen in equinus deformity of the foot, which is
commonly seen in club foot, spastic cerebral palsy, polio myelitis, post traumatic and post
burn contractures etc. Percutaneous Achilles tendon lengthening by triple level tenotomy
technique is based on sliding of partially cut tendon preserving its biology, strength and
biomechanics. This study aims to evaluate the efficacy and safety of this new surgical
therapeutic method.
Methods: A retrospective analysis of the Achilles tendon contracture cases in our hospital
between 2015 and 2020 was conducted. Fifty-one cases of equinus deformities treated with
percutaneous triple level Achilles tendon tenotomy. Operative time required, hospital stay,
wound healing, Achilles tendon rupture and equinus recurrence were recorded and
statistically analysed. American Orthopaedic Foot & Ankle Society (AOFAS) scoring system
was used to assess the Foot and ankle function.
Results: The mean follow-up period was 20 months. The mean operative time was 6 minutes
and mean hospital stay was 2 days. No cases had infection or wound healing complications.
One patient had equinus recurrence which was minimal. The mean AOFAS score increased
from 53% points before procedure to 96% at final follow-up.
Conclusion: This method of Achilles tendon lengthening by Triple level percutaneous
tenotomy significantly reduces operative time, hospital stay and thus expenses. Also this
technique is much better in maintaining soft tissue biology, strength and biomechanics thus
helping in preventing rupture of the tendon and recurrence of the deformity.